The thyroid, a small butterfly-shaped gland at the base of your neck just under the Adam’s apple, performs many important functions for your body. It manufactures hormones that help regulate energy production and metabolism, but having too little or too much of these hormones can have a major impact on your health and well-being. This disfunction is referred to as thyroid disease.
More than 12 percent of Americans develop a thyroid condition in their lifetime and women are five to eight times more likely than men to have thyroid issues. However, up to 60 percent of those with thyroid disease are unaware of their condition, according to the American Thyroid Association. This is due to the oftentimes vague or seemingly unrelated symptoms that tend to arise when your thyroid function is off. While the symptoms can be vague, the impact of undiagnosed thyroid disease can put you at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility.
So we spoke with Jessica Brown, M.D., an OB/GYN and physician on the medical staff at Texas Health Arlington, to highlight which subtle signs, or a mix of subtle signs, you should bring to your health care provider’s attention.
What Causes Thyroid Disease?
Thyroid disease can affect anyone at any age but women, especially those older than 60, are more likely to develop the disorder than men.
You may be at a higher risk of developing thyroid disease if you:
- Have a family history of thyroid disease.
- Have a medical condition (these can include pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome and Turner syndrome).
- Take a medication that’s high in iodine (amiodarone).
- Are older than 60.
- Have had treatment for a past thyroid condition or cancer (thyroidectomy or radiation).
What Are the Symptoms of Thyroid Disease?
There are two main types of thyroid disease: hypothyroidism and hyperthyroidism. Hypothyroidism is a result of an underactive thyroid, or low hormone levels, while hyperthyroidism, is due to an overactive thyroid that overproduces hormones. They can have some similar symptoms, but they also have some divergent ones as well, Brown says.
Too little thyroid hormone production (hypothyroidism) leads to symptoms such as:
- Feeling tired or fatigued.
- Having dry skin and hair.
- Feeling sensitive to cold.
- Experiencing constipation.
- Experiencing memory problems and depression.
- Gaining weight.
- Having a slow heart rate.
Whereas excessive thyroid hormone production (hyperthyroidism) leads to symptoms such as:
- Experiencing restlessness, anxiety, irritability and nervousness.
- Experiencing a racing heart and increased sweating.
- Having trouble sleeping
- Having an enlarged thyroid gland which may be visible under the skin.
- Feeling sensitive to heat.
- Experiencing sudden brittle hair and nails.
- Having muscle weakness and tremors.
- Losing weight
- Having vision or eye problems such as bulging eyes (in Graves’ disease)
According to the American Association of Clinical Endocrinologists (AACE), women are five times more likely than men to suffer from hypothyroidism. In women, thyroid issues can affect fertility because both hypothyroidism and hyperthyroidism affect the hormones that regulate ovulation and periods.
“Severe hypothyroidism is often associated with infertility and increased miscarriage rates,” Brown adds.
In 1989, then First Lady Barbara Bush didn’t seek guidance until she noticed her eyes had been puffy and irritated lately, overlooking a 20-pound weight loss. She was diagnosed with Graves’ disease, a type of hyperthyroidism.
“Many of the symptoms can be chalked up to stress or lack of sleep, aging, or can carry over as symptoms for more common issues, making a thyroid disorder easy to overlook,” Brown adds.
Diagnosing and Treating Thyroid Disease
If you suspect you are having issues with your thyroid, your physician will physically check your thyroid gland and look for any changes, such as smooth or dry skin, swelling, slower or faster reflexes, tremors or a slow or rapid heart rate. Then they will follow up with blood tests, the TSH (thyroid-stimulating hormone) test and T4 tests, to confirm or deny any suspicions they may have.
The TSH test measures how much of the hormone thyroxine (T4) the gland is being asked to make by the body. An abnormally high TSH signals hypothyroidism. The T4 tests measure how much T4 is in the blood and is available to be used by cells. A high level of T4 plus a low level of TSH commonly signals hyperthyroidism.
Although the United States Preventive Services Task Force has not yet found sufficient evidence to recommend routine thyroid screening of people without obvious symptoms, the American Association of Clinical Endocrinologists believes thyroid levels should be routinely measured in older people, especially women. And the American Thyroid Association recommends screening adults for TSH starting at age 35 and repeating the test every five years.
As far as treatment goes, thyroid disorders typically are lifelong but are generally easy to manage, says Brown. For hypothyroidism, you will be prescribed a replacement for the amount of hormone your thyroid can no longer make. For hyperthyroidism, treatment can range from antithyroid drugs, which block your thyroid’s ability to make new thyroid hormone, to radioactive iodine which targets and destroys thyroid cells, all the way up to surgical removal of all or most of your thyroid.
How to Keep Your Thyroid Safe
The direct cause of thyroid-related issues is unknown and there are no definitive ways to prevent thyroid disease, but there are things you can do to promote a healthier thyroid gland.
Ask for a thyroid collar during X-rays
Before you undergo X-rays, especially those that involve the head, neck, spine or chest such as dental X-rays, ask the technician or nurse to place a thyroid collar on your neck. The collar looks like the neck part of a turtleneck sweater and is heavy and lined with lead, just like the “jacket” that is placed over your chest during a dental X-ray.
This collar protects your thyroid from any excess radiation exposure.
Check your thyroid
Because symptoms can be so vague and seemingly unrelated, an annual wellness exam with your physician can help you keep an eye on your thyroid health, even if you or your physician may not suspect an issue. However, a visual check of your thyroid on your own can help detect issues before your next visit with your doctor.
All you need is a glass of water and a mirror. Focusing on the lower front area of your neck, above the collarbones and below the voice box, tip your head back just enough to where you can still see your neck. Take a drink of water and swallow, and as you swallow look at this area on your neck. Check for any bulges or protrusions as you swallow. You may want to repeat this multiple times to be sure. If you do see anything suspicious, see your physician.
Cigarettes have a variety of toxins that can affect your overall health, but also your thyroid. Thiocyanate, commonly found in cigarettes, disrupts iodine uptake, which can block the production of thyroid hormones. Smoking can also cause elevated T4 and decreased TSH levels.
Consider taking a selenium supplement
Selenium is a nutrient commonly found in specific proteins, and the thyroid has the highest concentration of selenium in the adult body. Even if you’re getting enough selenium through your diet, adding a supplement can still boost your immune system. If you and your doctor decide a selenium supplement is a good choice, opt for selenomethionine versus sodium selenite because it is absorbed better by the body.
Getting to know your individual thyroid health, risk factors and lifestyle changes can help you lessen your risk of issues, but keep in mind that nothing is a sure bet, especially if you have a family history, take prescription medications like lithium or amiodarone, or have experienced extensive radiation therapy to the head or neck. Talking to your physician about your risk factors and visiting them regularly can help keep an eye on any issues as they occur.